About Living Well

In response to the burgeoning older adult population in Jackson and Josephine Counties, the Rogue Valley Council of Governments’ Senior and Disability Services (RVCOG/SDS), will deliver and assess the effectiveness of Chronic Disease Self-Management programs (CDSMP) developed by Stanford University and explore the potential for broad-based use in southern Oregon. This effort responds to the increasing presence of aging adults in the Rogue Valley and the accompanying reality of increased longevity and its companion, chronic disease. According to The State of Aging and Health in America, 2004, 80+% of people, over age 65, have one chronic disease condition; 50% have two or more. In southern Oregon, there has been a 40% increase in the older adult population since the 2000 census, with half of all older adults expected to live to age ninety or beyond. The projected cost of health care for an elderly, chronically ill population challenges communities to explore new approaches. Chronic disease self management training has been used successfully throughout the United States and internationally to address improved health status and overall health management for aged, chronically ill individuals and their families.

The Chronic Care Model identifies the essential elements of a health care system that encourage high-quality chronic disease care. These elements are the community, the health system, self-management support, delivery system design, decision support and clinical information systems. Evidence-based change concepts under each element, in combination, foster productive interactions between informed patients who take an active part in their care and providers with resources and expertise. The model can be applied to a variety of chronic illnesses, health care settings and target populations. The bottom line is healthier patients, more satisfied providers, and cost savings.

Organizes internal and community resources to provide ongoing self-management support to patients

All patients with chronic illness make decisions and engage in behaviors that affect their health (self-management). Disease control and outcomes depend to a significant degree on the effectiveness of self-management.

Effective self-management support means more than telling patients what to do. It means acknowledging the patients’ central role in their care, one that fosters a sense of responsibility for their own health. It includes the use of proven programs that provide basic information, emotional support, and strategies for living with chronic illness. But self-management support can’t begin and end with a class. Using a collaborative approach, providers and patients work together to define problems, set priorities, establish goals, create treatment plans and solve problems along the way.

The CDSMP also has the potential to become an integral component in a strategic approach to reducing future public and private costs associated with an escalating aging population. At a time when health care resources are stretched maximally, the CDSMP teaches individuals to accept responsibility to manage or co-manage their own disease conditions, and more innovatively resolve their own disease management problems. It is built on a health promotion/wellness philosophy.

The 6-week Chronic Disease Self-Management Program (Living Well with Chronic Health Problems in Southern Oregon) was developed at Stanford University in the early 1990’s. It teaches individuals with diseases such as diabetes, arthritis, osteoporosis, asthma, cardiac difficulties and cancer how to more effectively manage their disease conditions. The approaches taught include:

techniques to deal with frustration, fatigue, pain and isolation

exercises for maintaining and improving strength, flexibility and endurance

improved health status (by their own assessment as well as the assessment of their health providers)

reduced emergency room use/doctor visits.

Our CDSMP offering uses the participation of local sites and trained volunteers to evaluate the effectiveness of chronic disease self-management approaches on participating individuals who attend the 6-week series. A pre- and post-workshop participation survey will provide input for a database by which to measure outcomes and effectiveness of the delivered program.

In addition, Spanish speaking individuals will be sent to Stanford University to be trained to present a version of the program specifically adapted to Hispanic populations and will be licensed to provide the training. This will offer the opportunity to deliver the program in the Spanish language community and lay groundwork for additional on-going delivery.

Living Well with Chronic Pain workshops are designed for people have who live with persistent pain in their daily lives. Often the participants in these workshops have been trying to cope with pain for many months or even many years. There are usually many different original causes of the chronic pain (spanning a wide range of illnesses or injuries) among the participants. There are many shared impacts of living with chronic pain such as, physical, emotional, social and mental challenges that affect those living with chronic pain. The living well workshops are both educational, interactive and supportive. The information provided is based on recent research and a curriculum designed by Stanford University Participants strengthen problem solving approaches and work toward reaching each participants individual goals to improve quality of life.

Workshops meet for 6 sessions, once per week for 2 1/2 hours each week. The workshops are facilitated by two trained leaders (one or both of whom live with chronic pain themselves).

Topics covered during this program include: understanding how chronic pain differs from acute pain symptoms; learning new ways to pace, plan and manage fatigue while doing activities that are important to each individual; improving communication with loved ones or healthcare professionals; dealing with difficult emotions; learning how to manage difficult decisions and problem solve when under stress; and working with medications, healthy eating and using your mind to manage symptoms.

Chronic Pain Self-Management Programs have been delivered to thousands of people and research in two major studies. Studies confirmed the participants who completed the workshop experienced more vitality, less pain, were less dependent on others, had an improved mental health and were more involved in everyday activities.

Living Well with Diabetes workshops are designed for people diagnosed with diabetes (type 1 or type 2) and those with pre-diabetes also are encouraged to participate.

Workshops meet for 6 sessions, once per week for 2 1/2 hours each week. The workshops are facilitated by two trained leaders (one or both of whom live with diabetes themselves). The Diabetes Self-Management Program is based on Stanford University curriculum and is recognized as an evidenced based program by the State of Oregon and the US National Center for Disease Control..

The Advisory Committee (AC) to this project includes administrative representatives of the Asante/Rogue Valley Medical Center, Providence Hospital, Ashland Community Hospital, La Clinic de Valle (a safety net community clinic system in Jackson County, serving Latino families), Jackson County Public Health, the Retired Senior Volunteer Program (RSVP) of Jackson and Josephine Counties, the Medford Senior Center, and the Veterans Administration (White City).

Funding is provided through a variety of resources, including state and federal Senior Services, public and private grants, health plans, workshop fees, and donations. Due to decreased grant funds a sliding scale fee schedule was developed. Oregon Health Plans in Jackson and Josephine County, some Advantage Medicare Plans and some private insurers provide members a benefit to attend these workshops.